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From Microbes to Matrons

Albert Carless (1863 - 1936)

Portrait of Albert Carless, 1920Portrait of Albert Carless, 1920. King's College Archives, KHMS/PH1/1/14Carless’ support for Lister and antisepsis was well known in medical circles. Not only did he serve as an assistant to Lister in 1889, and as a colleague of William Watson Cheyne, but his preference for antiseptics also appears in his Manual of Surgery, a textbook aimed at medical students he co-authored with fellow King’s surgeon William Rose (1847-1910) and first published in 1898.

Rose and Carless, like several other high profile surgeons of the period, viewed antisepsis as more reliable and easier to practice than asepsis, particularly in large city hospitals like King’s College Hospital.

In his Hospital report on cases of interest for the year in 1893/4, Carless states that opening the knee under asepsis is still ‘a measure fraught with risk in the hands of those who cannot maintain the wounds they have made in an aseptic state’.

The authors also nostalgically dedicate the 9th edition of their Manual to ‘Lord Lister, who first applied to surgery the principles that were being taught by Pasteur as to the microbic origin of disease’, and describe Lister as ‘one of the greatest benefactors of the human race’.

Carless had a lifelong interest in pathology, which he defined as ‘the imagination to connect all the elements into an intelligible theory of disease’. Yet, like Cheyne, he devoted his life to a clinical career, rather than one based in the laboratory. 

Carless played an important role in treating the wounds of soldiers on the battlefields of World War One where:

‘Gas gangrene was common; tetanus was rife; pyaemia was not infrequent; and every local septic condition that might develop did so with alarming frequency’.

Through the thorough mechanical cleansing of the wound after careful microscopic and bacteriological investigation, Carless and others were able to increase the healing rate of battlefield wounds to 70%. 

He retired from surgical work on demobilization in 1919, and devoted the rest of his life to philanthropic work. From June 1919 until 1926, he acted as honorary medical director at Dr Barnardo's Homes, where he did much good work. His Manual of Surgery, however, was republished throughout the twentieth century and became a medical school staple. 

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